Models of care for orphaned and separated children and upholding children's rights: Cross-sectional evidence from western Kenya

Lonnie Embleton, David Ayuku, Allan Kamanda, Lukoye Atwoli, Samuel Ayaya, Rachel Vreeman, Winstone Nyandiko, Peter Gisore, Julius Koech, Paula Braitstein

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Sub-Saharan Africa is home to approximately 55 million orphaned children. The growing orphan crisis has overwhelmed many communities and has weakened the ability of extended families to meet traditional care-taking expectations. Other models of care and support have emerged in sub-Saharan Africa to address the growing orphan crisis, yet there is a lack of information on these models available in the literature. We applied a human rights framework using the United Nations Convention on the Rights of the Child to understand what extent children's basic human rights were being upheld in institutional vs. community- or family-based care settings in Uasin Gishu County, Kenya. Methods. The Orphaned and Separated Children's Assessments Related to their Health and Well-Being Project is a 5-year cohort of orphaned children and adolescents aged ≤18 year. This descriptive analysis was restricted to baseline data. Chi-Square test was used to test for associations between categorical /dichotomous variables. Fisher's exact test was also used if some cells had expected value of less than 5. Results: Included in this analysis are data from 300 households, 19 Charitable Children's Institutions (CCIs) and 7 community-based organizations. In total, 2871 children were enrolled and had baseline assessments done: 1390 in CCI's and 1481 living in households in the community. We identified and described four broad models of care for orphaned and separated children, including: institutional care (sub-classified as 'Pure CCI' for those only providing residential care, 'CCI-Plus' for those providing both residential care and community-based supports to orphaned children, and 'CCI-Shelter' which are rescue, detention, or other short-term residential support), family-based care, community-based care and self-care. Children in institutional care (95%) were significantly (p < 0.0001) more likely to have their basic material needs met in comparison to those in family-based care (17%) and institutions were better able to provide an adequate standard of living. Conclusions: Each model of care we identified has strengths and weaknesses. The orphan crisis in sub-Saharan Africa requires a diversity of care environments in order to meet the needs of children and uphold their rights. Family-based care plays an essential role; however, households require increased support to adequately care for children.

Original languageEnglish
Article number9
JournalBMC International Health and Human Rights
Volume14
Issue number1
DOIs
StatePublished - Apr 1 2014

Fingerprint

Orphaned Children
Kenya
Africa South of the Sahara
Child Care
Aptitude
United Nations
Chi-Square Distribution
Self Care
Organizations
Health

Keywords

  • Children's rights
  • Kenya
  • Orphans
  • Street children
  • Sub-saharan africa
  • Vulnerable children

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Models of care for orphaned and separated children and upholding children's rights : Cross-sectional evidence from western Kenya. / Embleton, Lonnie; Ayuku, David; Kamanda, Allan; Atwoli, Lukoye; Ayaya, Samuel; Vreeman, Rachel; Nyandiko, Winstone; Gisore, Peter; Koech, Julius; Braitstein, Paula.

In: BMC International Health and Human Rights, Vol. 14, No. 1, 9, 01.04.2014.

Research output: Contribution to journalArticle

Embleton, L, Ayuku, D, Kamanda, A, Atwoli, L, Ayaya, S, Vreeman, R, Nyandiko, W, Gisore, P, Koech, J & Braitstein, P 2014, 'Models of care for orphaned and separated children and upholding children's rights: Cross-sectional evidence from western Kenya', BMC International Health and Human Rights, vol. 14, no. 1, 9. https://doi.org/10.1186/1472-698X-14-9
Embleton, Lonnie ; Ayuku, David ; Kamanda, Allan ; Atwoli, Lukoye ; Ayaya, Samuel ; Vreeman, Rachel ; Nyandiko, Winstone ; Gisore, Peter ; Koech, Julius ; Braitstein, Paula. / Models of care for orphaned and separated children and upholding children's rights : Cross-sectional evidence from western Kenya. In: BMC International Health and Human Rights. 2014 ; Vol. 14, No. 1.
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AU - Kamanda, Allan

AU - Atwoli, Lukoye

AU - Ayaya, Samuel

AU - Vreeman, Rachel

AU - Nyandiko, Winstone

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AU - Koech, Julius

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KW - Vulnerable children

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